We presented a review of literature for the history of development of shoulder prosthesis, and the relevant anatomy and biomechanics of the shoulder and their implication on prosthetic design. The clinical assessment of the shoulder, and the various scoring systems suggested by different authors were outlined, as well as the imaging modalities of the shoulder. A detailed review of the surgical technique of total shoulder arthroplasty was followed. All the possible complications are discussed in detail. Finally, the rehabilitation protocols for the shoulder are described.We have performed a clinical analysis of twenty total shoulder arthroplasties in rheumatoid arthritis. The indication for surgery in all cases was pain and limited function. The clinical results showed an improvement in the Constant score and the Shoulder Score Index of 31 and 54 respectively. There was satisfactory relief from severe disabling pain which was the main indication for surgical intervention. The presence of an intact rotator cuff was associated with improved function.